胎儿持续性心动过缓15例临床分析  

Clinical analysis of 15 cases of fetal persistent bradycardia

作　　者：陈施[1] 范丽欣[1] 孙笑[1] CHEN Shi;FAN Lixin;SUN Xiao(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,100034

出　　处：《中国妇产科临床杂志》2021年第6期616-618,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的了解胎儿持续性心动过缓常见的发病原因及新生儿预后。方法回顾性分析2013年1月至2020年1月在北京大学第一医院经胎儿超声心动检查诊断的胎儿持续性心动过缓病例15例的临床资料。结果 (1) 15例胎儿中,胎儿心动过缓合并胎儿心脏畸形3例,均选择终止妊娠;(2)房室传导阻滞8例,5例母体血清自身抗体anti-Ro(SS-A)联合anti-La (SS-B)阳性,其中足月分娩4例,2例新生儿放置永久起搏器;(3)房室1∶1传导胎儿心动过缓4例,均足月分娩,仅有1例出生后诊断为病态窦房结综合征,余预后良好。结论胎儿心动过缓首先要排除胎儿心脏畸形,其次要排查母体自身抗体异常所导致的房室传导阻滞,胎儿心动过缓的远期预后与病因密切相关。Objective To find out the common causes and prognosis of fetal persistent bradycardia.Methods Retrospective analysis was performed on 15 cases of fetal bradycardia diagnosed by fetal echocardiography in Peking University First Hospital from January 2013 to January 2020. Results(1) There were 3 cases of fetal bradycardia complicated with fetal heart malformation, All of them chose to terminate pregnancy.(2) There were 8 patients with atrioventricular block, the main cause of which was positive maternal serum autoantibody anti-Ro(SS-A) combined with anti-La(SS-B) in 5 cases. 4 cases delivery at term, permanent pacemakers were placed in 2 neonates.(3) There were 4 cases of fetal bradycardia with atrioventricular 1 : 1 conduction, all of which were delivered at term. Only one case was diagnosed as sick sinus syndrome after birth. Conclusion Fetal heart malformation should be ruled out in fetal bradycardia, and atrioventricular block mainly caused by abnormal maternal autoantibodies. The long-term prognosis of fetal bradycardia is closely related to the etiology.

关 键 词：胎儿心动过缓 房室传导阻滞 胎儿心脏畸形 抗-SSA/Ro抗体 抗-SSB/La抗体 

分 类 号：R714.5[医药卫生—妇产科学]